The woke roll back continues

It was a really well designed audit that looked at every possible risk factor in women who developed PE in pregnancy and post partum. Ante natal screening and prevention programmes were improved as a result.You have to look at everything in case you miss something important.

"A few years ago I mentioned my research into pulmonary embolism, race and ethnicity and was shouted down and accused of racism. If you can't properly identify who is at greater risk, you can't put strategies in place to make a difference."

It's ancestry that impacts biological differences, not race or ethnicity.

Race and ethnicity classifications are not grounded in science or biology and are not valid indicators for any biological differences between people (such as feeling pain, as described below). This is factual and something everyone should know as a starting point for any discussion.

Race and ethic classifications can be useful for exploring social issues and experience, but nothing more.

I think the primacy currently given to identity leads to people thinking identity is a determinate of much more than it actually is.

A few years ago I mentioned my research into pulmonary embolism, race and ethnicity and was shouted down and accused of racism. If you can't properly identify who is at greater risk, you can't put strategies in place to make a difference.

Well - there are also studies showing that there are people in healthcare who believe Black people are more able to tolerate pain and these attitudes have contributed to worse outcomes. A famous example include Serena Williams suffering a pulmonary embolism during childbirth and not being listened to.

And research not being inclusive is part of the problem. When it is - then research questions that matter to all communities can be prioritised. For example, there are many calls for inclusive research into things like the Apgar score - which flags when a newborn is at risk but still includes 'skin colour - blue or pale' - which obviously are not assessable in that way in Black babies.

So listening and further research are needed - the two are not mutually exclusive. We need research to drive understanding and we need research leadership to be inclusive to make that happen. The MRC and NIHR have accepted this and created streams of research funds to break down barriers and identify future research leaders from all backgrounds. Denial helps no one

Ridiculous comments suggesting listening precludes a focus on research are not helpful. Not only are they not true - they actually misinform the public!

DEI is working well in my organisation though there is still work to be done, of course.

This goes without saying. The DEI industry is worth $$$$$. There will always be work to be done.

Bur there is a tendency to shout racism at any problem and that can get in the way of addressing problems that are also significant and possibly more easily remedied. So the emphasis on the poor maternal outcomes for black women was all about getting people to listen. Listening is important but so is ensuring easier access to services near home and ensuring black women are more aware of the need for diabetes checks. The shouts of systemic racism were preventing the data analysis. Daring to suggest you actually investigate the contributing factors is itself deemed victim blaming and racist. There needs to be more studies like that looking at jaundice in newborns, less emphasis on changing words.

Many DEI specialists have completely bought into critical theory to explain inequality. CT is self-affirming, whereby objection and disagreement is interpreted as evidence that the theory is correct. This renders the theory infalsifiable. Any theory that immunises itself against any form of criticism is likely to get push back.

People who have experienced discrimination and unfair treatment are likely to find a theory that provides 'an irrefutable explanation' for this compelling.

Those who do not buy into the theory (in part or whole) are likely to be sceptical about it being self-affirming and react strongly to being 'called out' as a bigot for expressing doubts.

I cannot see a future for DEI approaches based on the above.

Yup - I can't. But the government can. Academic can. Hence the set up of the
NHS race and health observatory to enable long term transformational change. Because they, to their credit, choose to face facts and do something to address it.

https://www.nhsrho.org/

This! DEI is working well in my organisation though there is still work to be done, of course.

But none of that has to stop just because you don't have a dedicated DEI department at work. That's just a company that listens to employers.

Just as closing DEI departments doesn't mean there will suddenly be more discrimination. The Equality Act and employment law hasn't changed.

In my company all the DEI team do is arrange "allyship" meetings where people go and eat cake together. And send emails with rainbows on during Pride. They have no influence over whether manager X is a chauvinistic pig who doesn't hire women or employee Y is being sexually harassed by a colleague in a corridor.

Again your attitude is emblematic of some of the issues with people working in EDI. “I won’t be engaging further because I’m not open to the possibility that I am looking at this from an ideological standpoint”, ie that ‘systematic racism’ is the problem.

Yes of course there is racism and sometimes it is terrible. But you can’t state as fact that the NHS is systemically racist.

The Race and Equality initiatives in the NHS do use data but they are still underpinned by a lot of ideology that does not always get examined. Eg assuming that IMG get more referrals to the GMC because of racism (rather than because of cultural or communication issues). The NHS is also very focused on race and gender/gender ID and really struggles to look at social class.

Totally agree with you. From my experience it's a TRA shindig.

https://www.newhamrecorder.co.uk/news/23598990.moorfields-eye-hospital-racially-discriminated-worker/

This is a case where the senior imaging lead would imitate Filipino and other accents and movements when speaking

https://www.manchester.ac.uk/about/news/discrimination-is-the-biggest-career-obstacle-for-women-of-colour-in-the-nhs/

This is a commentary on racism and career trajectory that highlights the lack of granular data on a systems-wide basis until 2022. Individual specialties publish their own detailed demographics and career trajectory in the academic literature.

I won't be commenting further because this isn't really about convincing you or anyone else. The UK suffers from systemic discrimination and racism that are embedded and will take time and concerted effort to sort. The data is there for those that care and want to contribute to well-thought out solutions

And if you are truly interested - Google NHS Workforce Race Equality Standards and the various reports since 2014. Insert racism in the NHS in Pubmed - and you will see the multiple academic papers on the topic. Good bed time reading. Famous for the wrong reasons.....

I'm afraid you are talking to a researcher who does analysis for a living and the Race and Equality Standards teams are made up of Professors and statisticians who delve into the granular details. At least for the NHS.

There are also multiple peer-reviewed academic papers published on the granular detail

In the case of the NHS (and healthcare in many Western jurisdictions) - the analysis is granular. Based on this, there is now a team within NHS England dedicated to supporting internationally qualified medical staff and separately for internationally qualified nursing/midwife staff. Some of the solutions that are being incorporated include bespoke induction programmes and mentors to ensure they embed etx. This is because these individuals have a higher rate of verified bullying and harassment and unjustified referral to regulators. Of course the teams delivering the induction and mentorship and some of the other solutions being rolled out are being paid. Racism is expensive

I still think we'd need to look carefully at a much further breakdown of the populations to have anything very useful to say about what's going on.

One of the things that is worst about the DEI lens is that it almost always uncritically accepts disparities as having their origin in some kind of discrimination, and the fact is that is very often not the case, or it's far more complex set of relations. In this case my first question would be about nurses who have not been brought up in the UK, and also possibly where they were educated. I'd want to see the age breakdown and median ages of the cohort. But also things like the type of career trajectory would be very worth looking at.

Unless there are attempts to do such a granular analysis, I am very disinclined to accept claims around causation, for me these kinds of initiative have lost any assumption of good practice statistically speaking, and fair play as well.

The example up top is about nurses and when the data is analysed it is analysed by roles. So demographics of nurses across all bands, separate to physiotherapists separate to doctors etx

It is certainly most stark amongst nurses but similar patterns across many healthcare roles in the NHS.

And most of the data is public and available.

So you are saying these are all people in the same roles, with the same kind of education?

Because "healthcare" includes all kinds of different roles that require totally different types of education. Which did not seem to indicate you meant people in the same roles.

I think this is pretty clearly the case.

It really doesn't seem that credible that you can have many women being very successful in certain scientific fields, but all of a sudden when it comes to physics the whole thing is so sexist that women can't get a look in. Especially when we consider that the women who do pursue it and are suited can do quite well.

Some give the explanation that it is because girls are not encouraged to go into those areas, but then, we see all kinds of efforts to do just that indifferent places, and it doesn't seem to make much difference.

One area where I think there is a kind of gap is that in my observation, women in the sciences will tend somewhat toward areas that are more easily combined with balanced home life. So my dh works in the civil service as a scientist. Women aren't really dominant in his area, but there are a lot of them in government sections. His view is they tend to go forthosejobs because they have reasonable, regular hours and good benefits, maternity leave, and so on.

I don't really see that as a bad thing either though. I don't think having every work sector completely mirroring the population is all that important.

I think one of the major issues with DEI is that it starts with the assumption that all disparity is caused by sexism/racism/discrimination. Now obviously this is sometimes true but it is not always or even mostly true, and it certainly shouldn’t be assumed to be true with no evidence. This is a major problem because if you fixate on discrimination you don’t address the massive elephants in the room: education, social class, culture, family, preference. It is in the interests of EDI departments to ignore these things because mostly it is not in their gift to address them. If they said, “ actually education is the major issue here”, they would do themselves out of a job.

I do wonder if now DEI is mainstream, there is a niche appeal in being anti it, to appeal to an audience who want to swig Jack Daniels whilst riding their Harley (or men who'd like to imagine that's what their life is like).
I wonder what the reality is within these companies- whether dumping DEI actually means they've dumped benefits for gay or unmarried couples for e.g, or whether that all quietly carries on.

I think it would be a shame if we lost all DEI initiatives.
TW in my workplace are often senior men who have transitioned later in life, usually once they have reached a relatively high rank and have lots of experience. I don't think they will be much affected by dumping DEI.
The group I see benefitting most from these policies where I work are disabled people, who are actually reliant on reasonable adjustments to enable them to work- and it can sometimes be a fight to get them, although there has been a vast improvement over the past ten years or so.
The largest numbers of initiatives where I work are for women, and there has been a steady increase in the number of women in senior roles over a similar timeframe. We are also seeing a marked increase in the number of female engineering graduates coming through, possibly thanks to wider societal 'women in STEM' initiatives.
I can't see it benefitting anyone other than mediocre white men if it's all done away with.

Also all newly qualified nurses start at Band 5 - they all need degrees - so all come in at the same educational level. And some may not want the responsibility of management or even seniority but it is important to ensure we are not losing people who are talented and passionate just because they are different